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Revidierte Fassung der 4. Ausgabe der WHO-Klassifikation maligner Lymphome

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Revised version of the 4th edition of the WHO classification of malignant lymphomas

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Zusammenfassung

Nach 8 Jahren liegt nun eine Neufassung der 4. Ausgabe der WHO-Klassifikation lymphatischer Neoplasien vor. Sie beinhaltet sowohl eine konzeptionelle Neufassung bestehender Entitäten wie auch – wenige – provisorische neue Entitäten bzw. Kategorien, vor allem unter den aggressiven B‑Zell-Lymphomen. Hier sind vor allem das High-grade-B-Zell-Lymphom, das großzellige B‑Zell-Lymphom mit IRF4-Translokation und das Burkitt-ähnliche Lymphom mit Aberrationen in 11q zu nennen. Von besonderer Bedeutung sind auch neuere Konzepte zur Taxonomie und Klassifikation früher lymphatischer Läsionen bzw. möglicher Vorstufen, wie die in-situ follikuläre Neoplasie und die in-situ Mantelzellneoplasie, die Beschreibung indolenter Lymphoproliferationen wie das Brustimplantat-assoziierte anaplastische großzellige Lymphom und die indolente T‑Zell-Lymphoproliferation des Gastrointestinaltrakts sowie generell die Schärfung diagnostischer Kriterien bestehender Entitäten.

Abstract

After 8 years, the WHO has now published the updated version of the 4th edition of the classification of hematopoietic and lymphoid tumors. This update provides a conceptual rewrite of existing entities as well as some new provisional entities and categories, particularly among the aggressive B‑cell lymphomas. Important new diagnostic categories include the high-grade B‑cell lymphomas, the large B‑cell lymphoma with IRF4 rearrangement, and the Burkitt-like lymphoma with 11q aberrations. Of particular importance, new concepts concerning the taxonomy and classification of early lymphoid lesions or precursor lesions are included, such as the in situ follicular neoplasia or the in situ mantle cell neoplasia. In addition, the concept of indolent lymphoproliferations, such as breast-implant-associated anaplastic large cell lymphoma and the indolent T‑cell lymphoproliferative disorder of the gastrointestinal tract, has been strengthened. Finally, diagnostic criteria for existing lymphoma entities have been refined.

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Correspondence to G. Ott.

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G. Ott, W. Klapper, A. C. Feller, M. L. Hansmann, P. Möller, H. Stein, A. Rosenwald und F. Fend geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. A. Baba, Essen

Die Autoren sind Mitglieder des Deutschen Referenzpathologie-Panels des Kompetenznetzes Maligne Lymphome e. V.

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Ott, G., Klapper, W., Feller, A.C. et al. Revidierte Fassung der 4. Ausgabe der WHO-Klassifikation maligner Lymphome. Pathologe 40, 157–168 (2019). https://doi.org/10.1007/s00292-018-0456-4

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